Feb 15, 2007 - Moral distress in the neonatal intensive care unit: caregiver's experience. A Janvier, S Nadeau, M Deschênes, E Couture and KJ Barrington.
Journal of Perinatology (2007) 27, 203–208 r 2007 Nature Publishing Group All rights reserved. 0743-8346/07 $30 www.nature.com/jp
ORIGINAL ARTICLE
Moral distress in the neonatal intensive care unit: caregiver’s experience A Janvier, S Nadeau, M Descheˆnes, E Couture and KJ Barrington Department of Pediatrics, McGill University, Montreal, Quebec, Canada
Background: The Neonatal Intensive Care Unit (NICU) can be ethically charged, which can create challenges for health-care workers.
Objective: To determine the frequency with which nurses and residents have experienced ethical confrontations and what factors are associated with increased frequency. Design/Methods: An anonymous questionnaire was distributed to nurses in a university center, a high-risk obstetric service, a maternity hospital NICU with 85% in-born patients and an outborn NICU, most of whose preterm admissions are those with surgical complications. Obstetric and pediatric residents in the four universities of the province also received the questionnaire, which included demographics, opinions regarding the gestational age threshold at which resuscitation of a premature infant with bradycardia was appropriate, knowledge of cerebral palsy (CP) outcomes (as an indicator of knowledge about long-term sequelae of prematurity) and questions about ethical confrontation in the NICU. Results: Two hundred and seventy-nine caregivers participated (115 full time nurses and 164 residents). All the distributed questionnaires were completed. Frequent ethical confrontation was reported by 35% of the nurses and 19% of the residents. Among the nurses, moral distress differed significantly between work environments. Nurses working in an out-born NICU and obstetric nurses were more likely to overestimate CP prevalence (P
